Homology spheres and fundamental group I have a curiosity about homology spheres: I was wondering if they were uniquely characterized by their fundamental group. I.e. given two $n-$dimensional (integral) homology spheres with isomorphic fundamental groups, are they homeomorphic? If not, how many homeomorphism classes corresponds to a given fundamental group?
 A: See edit at bottom for further information answering the question in all dimensions.
In all odd dimensions $2k -1 > 3$, there are non-homeomorphic homology spheres with fundamental group G = the binary icosahedral group (fundamental group of the Poincaré homology sphere). This follows from basic surgery theory; the Wall group $L_{2k}(G)$ contains a subgroup of the form $\mathbb{Z}^n$ for some $n$ related to the number of irreducible complex representations of $G$. This subgroup is detected by the so-called multisignature, as described in Wall's book on surgery theory. 
Choose one homology sphere $M^{2k-1}$ with $\pi_1(M) = G$. For instance, you can repeatedly spin the Poincaré sphere, where spinning $P$ means doing surgery on the obvious $S^1$ in $S^1\times P$. For any $M$ with $\pi_1(M) = G$, there's an invariant originally described by Atiyah and Singer. A priori, it's a smooth invariant, but is known to be a homeomorphism invariant. Roughly speaking, one knows that for some $d \in \mathbb{N}$, the manifold $d\cdot M$ is the boundary of a $2k$-manifold $X$ with $\pi_1(X) = G$.  Then $X$ has a collection of equivariant signatures (associated to the action of $G$ on the universal cover of $X$), known collectively as the multisignature.  The multisignature (divided by $d$) is a topological invariant. (Technically, this is only well-defined up to a choice of isomorphism $\pi_1(X) \to G$ but this is readily dealt with.)
Now, the group $L_{2k}(G)$ acts on the structure set of $M$, as described in Wall's book. The effect of the action is to change the multisignature, and hence it changes the homeomorphism type of $M$. In this construction, you not only preserve the fundamental group, but also the (simple) homotopy type of $M$.
It's possible that acting on an even-dimensional homology sphere $M^{2k}$ with fundamental group $G$ by elements of $L_{2k+1}(G)$ could change the homeomorphism type. But odd dimensional $L$-groups are much harder, and you'd need some serious expertise to see what the effect should be. I rather suspect that you could do something simpler, and change the homology with local coefficients or something like that.
Addendum: There are two papers of Alex Suciu that answer this question in dimensions at least 4.  In "Homology 4-spheres with distinct k-invariants," Topology and its Applications 25 (1987) 103-110, he gives examples of homology 4-spheres with the same $\pi_1$ and $\pi_2$ that are not homotopy equivalent. In "Iterated spinning and homology spheres", Trans AMS 321 (1990) he constructs homology n-spheres in dimensions $n \geq 5$ with the same property. Combined with the remarks above about dimension 3, this answers your question.
